Chemotherapy consists of the administration of drugs that destroy cancer cells. Cancer cells are some of the most rapidly reproducing cells in the body, but other cells, such as those which contribute to the formation of hair shafts and nails, are also rapidly reproducing. Unfortunately, while chemotherapy drugs preferentially destroy cancer cells, the drugs can also destroy those cells responsible for normal growth of hair and nails. Cancer patients sometimes shed the hair and nails during treatment. Chemotherapy drugs are poisonous to the cells of the hair root responsible for hair shaft formation. Usually, the hair is lost rapidly in large quantities during treatment. No hair growth stimulates, shampoos, conditioners, or other cosmetic treatments can prevent or retard the hair loss. The good news, however, is that once chemotherapy is completed, the hair usually grows back.

Adequate hair growth may take six months to one year.

Returning hair may be different from the hair that was lost. Due to the absence of pigment the hair may grow back white, gray or a different color. Eventually, as the pigment cells return to normal, the original color should return. It is common for the new hair returning to be finer in texture initially, but like color, the texture should return to its original thickness.It is sometimes difficult to be patient, but as the body is returning to normal and getting over the significant insult, time is a necessary ingredient.

Shampoo hair twice a week with a mild shampoo such as those intended for dry or damaged hair.The scalp should also be massaged to remove any scale.Follow the shampoo with a conditioner for fine or limp hair. Avoid high heat from blow dryers to the hair or skin. Keep hairstyling to a minimum due to the new hair being prone to breakage. Brushing, combing, hairpins and curling irons all should be minimized.

Hair stying aids such as mousse, hair spray and gel should be used in moderation. It is best to select products with light holding abilities as the high hold products may not be completely removed with mild shampoos. Hair styling aids can build up on the shaft resulting in dullness and possibly scalp disease.

A word of caution to parents with children undergoing chemotherapy. The absence of hair can be used in a positive manner. It can signal to others handle with care.

While undergoing chemotherapy the child has a low blood count and can be bruised easily. The instance of parents, however well meaning, for a child to wear a wig or prosthesis can signal the message: You're not ok the way you are.

A child should have all the options but the choice should be his or hers. Hugs and tender care are all that is necessary from the parents.

At the onset of hair loss, (the very first hair fall) some patients choose to shave their total scalp. Their reasons are the following:

• The elimination of uncontrolled hair fall and embarrassing shedding.
• Some feel that total baldness is more attractive than the spotty hair loss (especially males).
• Many believe that after 25-50% hair loss, males or females look healthier with no hair at all.
• Shaving facilitates prosthetic hair security and comfort (ie: vacuum bases, two way tape and other adhesives for hair prosthesis)
• What may seem extreme to some, may not be for others.
• Attractive head coverings are available from a variety of manufacturers as an alternative to wigs.